NPIMap

Organization Active NPI

Ehpp Chestnut Ridge LLC

Doing business as Excela Chestnut Ridge Ligonier

  • Non-Pharmacy Dispensing Site
  • Ligonier, PA
National Provider Identifier
1033356290
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
MD016675 Issued in PA
Legal business name
EHPP CHESTNUT RIDGE LLC
Doing business as
Excela Chestnut Ridge Ligonier
Practice address
117 W Wellington Aly
Ligonier, PA 15658-6201
Phone
(724) 238-6668
NPI assigned
Jan 9, 2009
Last updated
Jul 19, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X MD016675 PA Primary

Addresses

Primary practice location

117 W Wellington Aly
Ligonier, PA 15658-6201

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701

Other names 1

  • Excela Chestnut Ridge Ligonier Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ehpp Chestnut Ridge LLC8 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1033356290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W WELLINGTON ALY",
            "city": "LIGONIER",
            "state": "PA",
            "postal_code": "156586201",
            "telephone_number": "724-238-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EHPP CHESTNUT RIDGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-01-09",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD016675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Chestnut Ridge Ligonier",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ligonier, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.